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美国皮肤癌方面的种族和族裔医疗差异:对现有不平等现象、促成因素及潜在解决方案的综述

Racial and Ethnic Healthcare Disparities in Skin Cancer in the United States: A Review of Existing Inequities, Contributing Factors, and Potential Solutions.

作者信息

Shao Kimberly, Feng Hao

机构信息

Both authors are with the Department of Dermatology at University of Connecticut, Farmington, Connecticut.

出版信息

J Clin Aesthet Dermatol. 2022 Jul;15(7):16-22.

Abstract

OBJECTIVE

Racial and ethnic health disparities affect the diagnosis and management of melanoma and nonmelanoma skin cancers, leading to deleterious outcomes. Non-Hispanic White patients make up the majority of skin cancers cases, yet racial and ethnic minorities have poorer prognoses and outcomes. The skin cancer literature is fragmented with regards to potential contributors to these healthcare disparities. In this article, we provide a comprehensive review of the skin cancer literature to briefly quantify racial and ethnic inequities, highlight contributing factors, and propose practical changes that can be made.

METHODS

A PubMed search was completed to identify articles related to racial and ethnic health care disparities in the context of melanoma, basal cell carcinoma, squamous cell carcinoma, Merkel cell carcinoma, and dermatofibrosarcoma protuberans.

RESULTS

Relative to non-Hispanic White patients, patients of racial and ethnic minorities have differing clinical presentations of skin cancers and genetic risk factors. Insurance, access to specialty care, cultural beliefs, and available educational resources further contribute to racial and ethnic disparities.

LIMITATIONS

We are limited to the level of detail provided in the existing literature, and at some times are unable to distinguish race of Hispanic populations. We also acknowledge that there are different nationalities grouped under these broad labels as well as multi-racial populations that may not be accounted for.

CONCLUSION

Awareness of and familiarization with innate factors and potentially more modifiable contributors can help inform efforts to close the observed gap in racial and ethnic inequities.

摘要

目的

种族和民族健康差异影响黑色素瘤和非黑色素瘤皮肤癌的诊断与管理,导致不良后果。非西班牙裔白人患者占皮肤癌病例的大多数,但少数种族和民族患者的预后较差。关于这些医疗保健差异的潜在因素,皮肤癌文献较为零散。在本文中,我们对皮肤癌文献进行全面综述,以简要量化种族和民族不平等现象,突出促成因素,并提出可行的改进措施。

方法

完成一项PubMed检索,以识别与黑色素瘤、基底细胞癌、鳞状细胞癌、默克尔细胞癌和隆突性皮肤纤维肉瘤背景下的种族和民族医疗保健差异相关的文章。

结果

相对于非西班牙裔白人患者,少数种族和民族患者的皮肤癌临床表现和遗传风险因素有所不同。保险、获得专科护理的机会、文化信仰和可用的教育资源进一步加剧了种族和民族差异。

局限性

我们受限于现有文献提供的详细程度,有时无法区分西班牙裔人群的种族。我们也承认,在这些宽泛标签下有不同国籍的人群以及可能未被涵盖的多种族人群。

结论

了解并熟悉内在因素和可能更易改变的促成因素,有助于为缩小观察到的种族和民族不平等差距的努力提供信息。

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